March 17, 2017 — Mercury used to be commonplace in a variety of products used in health care settings, including thermometers, cleaning agents and electronic devices, such as fluorescent lamps and computer equipment. Mercury is a dangerous toxin that can be harmful to humans, including to the brain and kidneys. It can be absorbed through cuts and abrasions in the skin. Studies show that mercury makes its way into our nation’s rivers, lakes, streams and drinking water, jeopardizing human health and the environment. Twenty-five years ago health care leaders across the nation worked to remove mercury from operations, and they  have succeeded in significantly phasing out the use of the chemical, replacing it with safe, cost-effective alternatives.

Since then, progress on health care sustainability has continued. Today we’re seeing efforts to tackle root causes and complex, sectorwide problems like climate change and greening the supply chain — reducing health care’s impact on the environment and the environment’s impact on public health.

However, as political winds shift at the federal level, some are questioning whether advancements in sustainability can continue. Can health care afford sustainability when the very business model that funds health care is in flux? Or is sustainability simply a “nice to have” initiative for good times that must be cut when the federal insurance market changes?

The truth is, the benefits delivered from environmental initiatives are far too connected to health care’s mission and operations for the industry to change course. In fact, because sustainability strategies reduce operating costs and create better patient outcomes, many hospitals and health systems are doubling down on them, hoping the gains they reap will position them to weather market changes to come.

Recognizing climate change as one of the greatest health issues of our time, U.S. hospitals are stepping up efforts to reduce carbon emissions.

It is true that some sustainability efforts are expensive, and if cost cutting becomes necessary, they may fall by the wayside. However, many commitments to sustainability in key areas are likely to continue. These include cost-saving initiatives like reducing waste reduction, conserving water, boosting energy efficiency and serving healthy food. The latest data and trends compiled in the 2016 Sustainability Benchmark Report from Practice Greenhealth — an international coalition of organizations, hospitals and health partners I founded and for which I serve as president — show that the push for green health care has never been stronger. Below are a few highlights.

Clean energy moving mainstream. Recognizing climate change as one of the greatest health issues of our time, U.S. hospitals are stepping up efforts to reduce carbon emissions. Our report shows that over the past three years, the percent of facilities that have a written plan to mitigate climate change has nearly doubled.

From a financial perspective, reducing energy consumption nearly always pencils out: Because hospitals operate 24/7, a typical hospital’s annual energy bill runs into the millions, depending on size and location. A growing number of facilities are moving beyond energy efficiency to renewable energy sources to save money and reduce carbon emissions. According to our report, the percentage of facilities that generate or purchase renewable energy has increased 82 percent in the past three years. These hospitals are reaping financial savings over time, and with the advent of power purchase agreements, many hospitals can get a decades-long guaranteed return from renewable energy with no upfront installation costs. By moving away from fossil fuels, these facilities also align with their health missions, reducing direct health care costs associated with asthma attacks, chronic bronchitis and other health problems linked to power plant emissions.

New strategies driving waste reduction. Waste is one of the most visible environmental issues associated with hospitals and health care systems, both in terms of the quantity of waste generated and the complexity of managing it appropriately. Waste reduction will continue to be a key area of focus for hospitals, because it produces substantial cost savings.

Hospitals are realizing cost savings from preventing food waste up front and managing it on the back end through efforts like composting or food donation programs.

Many hospitals have implemented recycling programs that reduce waste and reduce their extremely high disposal costs. (Medical waste disposal costs can be nearly five times those for traditional waste.) According to our data, leading hospitals are routinely achieving a 30 percent recycling rate.

With up to 25 percent of a hospital’s total waste coming from food, a growing number of facilities are targeting food waste. Hospitals are realizing cost savings from preventing food waste up front and managing it on the back end through efforts like composting or food donation programs. Because rotting food in landfills produces methane, a potent greenhouse gas, food waste reduction is also a climate mitigation strategy.

Higher demand for sustainable products. The products that health care providers buy have environmental and human health impacts that often aren’t considered in traditional purchasing processes. Products like furniture, bedding and medical supplies can contain toxins that are harmful to patients when in use and harmful to the environment when discarded. Because of this, we have found more and more hospitals are using “environmentally preferable purchasing.”

The demand for furniture free from toxic flame-retardants is a powerful example. In recent years, several major health care systems have pushed suppliers to provide furniture without this harmful chemical that’s linked to reproductive problems, cancer and developmental delays. This has resulted in a reported reduction in the cost of furniture for some hospitals, while others report that the switch to furniture free from toxic flame-retardants is now cost neutral. In 2016, the percent of hospitals prioritizing furniture and medical furnishings free of halogenated flame retardants, formaldehyde, perfluorinated compounds and PVC grew by more than 55 percent from the previous year.

Our data reveal how deep and wide health care’s efforts in sustainability are, and how embedded these kinds of actions are in the very business model.

As our knowledge of the hazards of certain commonly used chemicals found in traditional medical supplies and products grows, more health care facilities are considering environment and human health in every purchasing decision and allocating a growing percentage of their budgets to sustainable products and services. As result of this demand, we are seeing market transformation — more of these products have become available at the volumes necessary for large buyers to purchase, while costs are going down. Our hope is that just as public health and health care changed the conversation and behavior around tobacco and mercury across multiple industries, health care will now drive change back into the supply chain for other large buyers of products and services, including schools, governments and universities.

Hospitals Will Continue to Lead 

Although health care is currently in flux, it isn’t running from environmental stewardship. Our data reveal how deep and wide health care’s efforts in sustainability are, and how embedded these kinds of actions are in the very business model. We believe health care will remain on the forefront of sustainability because it’s good business, it’s good for communities and it’s better for people’s health. View Ensia homepage

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